Central and Travis Service Area

Value‑Added ServicesCustomer Service: 1‑877‑688‑1811 (TTY: 711)Central Service Area Member Advocate: 1‑855‑497‑0857 (TTY: 711)Travis Service Area Member Adovcate: 1‑877‑375‑9097 (TTY: 711)

www.bcbstx.com/starkidsEffective September 2021

Value-Added Services may have restrictions and limitations.Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield AssociationSKM-6009 731305.0721

What do you get with Blue Cross and Blue Shield of Texas?Reliability and experience. Blue Cross and Blue Shield of Texas (BCBSTX) has been bringing health care services to Texans for more than 90 years. BCBSTX serves STAR Kids members in the Travis and Central Service Areas.

BCBSTX Value‑Added Services OverviewBCBSTX has many Value-Added Services (VAS) to help members stay healthy. These services are offered at no cost to you: • Free rides for BCBSTX member meetings and events, approved

health classes and more • Up to eight hours of extra respite care for STAR Kids members in

the Medically Dependent Children Program (MDCP) • $75 gift card for taking children birth through 15 months for a yearly

Texas Health Steps checkup • $25 gift card for members ages 12 to 21 when they get a yearly well

checkup • Upgraded eyewear up to a $150 value each year, after an eye exam • One free sports and camp physical each year • Members can get up to 14 meals delivered to their home after a

hospital discharge for a total of two separate events per year • Hippotherapy or therapeutic riding services include one

evaluation and up to 10 therapy sessions per year • $25 gift card , up to four times a year, for Parents/Legally Authorized

Representatives (LARs) who attend a Member Resource Meeting • Reimbursement for Summer Camp Enrollment Fees up to $100 • Choice of an infant car seat or a pack‑and‑play playard when

pregnant members complete a timely prenatal visit and register for our Special Beginnings® program

• BCBSTX prenatal class and a free diaper bag with baby items for pregnant members

• Pregnant members can get a $25 gift card for timely completion of the first prenatal visit.

• Earn a $25 gift card for timely completion of a postpartum visit after delivery.

• Breastfeeding Education through our Special Beginnings Program • $50 of fresh fruits and vegetables delivered to the home for

pregnant members • Online Behavioral Health (BH) resources • Incentive gift card for getting follow‑up care after a BH

inpatient discharge • Access to Aunt Bertha online health and wellness resources • Get access to the Blue365® Discount Pharmacy Program

Details About Our VAS • Extra Help Getting a Ride: BCBSTX offers STAR Kids members free

rides to non-emergency visits that are not covered by Texas Medicaid. This includes rides to non-emergency doctor visits, therapy, VAS (such as Hippotherapy), approved health classes and special BCBSTX events and member meetings. You can also use the VAS for covered services where the parent needs to bring more than one child. Call ModivCare at 1‑855‑933‑6993 (TTY: 711) 8 a.m. to 5 p.m. Central time, Monday to Friday to schedule your ride at least three days before the scheduled visit or 24 hours before a sick child visit using the BCBSTX VAS.Limitations: Before asking for Extra Help Getting a Ride, STAR Kids members should first call ModivCare to ask for rides to medical appointments and other related services through the Non-Emergency Medical Transportation (NEMT) program at no cost to you. BCBSTX contracts with ModivCare to provide NEMT as a covered benefit through Texas Medicaid. Medicaid also covers trips for urgent care, a ride home after a discharge from a hospital, or travel to the pharmacy with less than 48-hours’ notice. Call 1‑866‑824‑1565 (TTY: 711) for more information about NEMT or to schedule a ride between 8:00 a.m. and 5:00 p.m. Central time, Monday through Friday. VAS rides must be scheduled at least three days before the ride is needed. This transportation benefit is for non-emergency rides and does not include rides in an emergency situation. Let ModivCare know ahead of time if you need a wheelchair van. Ask ModivCare about how to get reimbursement for transportation costs.

• Extra Help for Parents/Respite care for parents/LARs: BCBSTX offers a respite care VAS for members in the Medically Dependent Children Program (MDCP). This VAS provides an extra eight hours per month of respite care in addition to the covered benefit of respite services. Members can continue to use their existing respite care provider for this VAS. This allows STAR Kids members to work with a provider who already understands their health care needs.Limitations: This service is for STAR Kids MDCP members only. Parent or LAR must work with BCBSTX service coordinators to get the respite care VAS and to select the appropriate respite care provider. Parents and LARs will be limited to eight hours of respite care per month with their existing or selected respite care provider. This VAS does not count against any covered respite benefits. Members must be current on their service coordination plan to be eligible. This service is limited to 6 a.m. to 8 p.m., Central time. It is not intended for overnight use. Respite care providers must be willing to bill BCBSTX by invoice for members to get this service.

• Texas Health Steps Incentive Checkup Gift Cards: BCBSTX offers gift cards for taking your children to their yearly Texas Health Steps checkups. You can get a $75 gift card by taking your baby to the doctor at least six times from birth through 15 months old.Limitations: Parents or guardians of child members must make sure their baby gets Texas Health Steps checkups as listed above. Members must be active on the plan to get the gift card, and checkups must be completed by an in-network Primary Care Provider (PCP). The member/parent/guardian must also register through the gift card program portal to receive the gift card at the address listed in the registration. Members will receive information in the mail after the qualifying visit that will instruct you on how to register for the program. Gift card awards are based on claims your doctor will send to BCBSTX after the checkup is completed. Once your doctor sends BCBSTX the claim, it could take up to two months for you to get the gift card.

• Incentive Gift Cards for Adolescent Checkups: Adolescent STAR Kids members ages 12 to 21 can earn a $25 gift card when they visit their PCP or OB/GYN for a yearly Texas Health Steps checkup.Limitations: Parents or guardians of adolescent members must make sure their children get a Texas Health Steps checkup each year. Members must be active on the plan to get the gift card and checkups must be completed by an in-network PCP or OB/GYN. The member/parent/guardian must also register through the gift card program portal to receive the gift card at the address listed in the registration. Members will receive information in the mail after the qualifying visit that will instruct them on how to register for the program. Gift card awards are based on claims your doctor sends to BCBSTX after the checkup is completed. Once your doctor sends BCBSTX the claim, it could take up to two months for you to get the gift card.

• Enhanced Eyewear: STAR Kids members can get one upgrade to eyewear, such as one pair of stylish frames (upgraded from basic frames), upgraded lenses, or an extra pair of glasses every year after they complete an eye exam. Children must complete an eye exam before using this VAS. Call Customer Service for more information. Limitations: The upgrade may not go above a $150 value each year. This VAS must be fulfilled by an in-network Davis Vision provider.

• Sports and Camp Physicals: We help STAR Kids members take part in sports and fitness activities by offering free sports and camp physicals.Limitations: Sports and Camp physicals are limited to one physical each year for STAR Kids members.

• Reimbursement for Summer Camp Enrollment Fees: Parents/guardians/LARs of members may request reimbursement for summer day camp participation by contacting STAR Kids Member Outreach at 877-375-9097. Parents/guardians/LARs must provide a receipt for payment to Outreach for reimbursement. Limitations: The maximum reimbursement is up to $100 for summer day camp enrollment fees. Funds can only apply to approved Day Camps that are not camps covered through the MDCP camp benefits.

• Prenatal Care Incentive Options: Pregnant STAR Kids members who complete a timely prenatal visit AND register for our Special Beginnings program can choose an infant car seat or a pack and play playard. The prenatal visit must occur in the first trimester or within 42 days of joining our plan to be eligible. You can find the Prenatal Care Incentive Options Form on our website at bcbstx.com/starkids or call BCBSTX Customer Service. Take the form to your doctor to sign during your prenatal visit and fax it to Member Outreach at 1‑512‑349‑4867. The car seat or pack and play playard will be sent to the address you put on the form.Limitations: You must be active on the plan when completing your prenatal visit in the first trimester or within 42 days of joining the plan. You must also be registered for the Special Beginnings program to get the infant car seat or pack or play playard.

• Prenatal Class with Incentive Diaper Bag: What health education classes does BCBSTX offer? BCBSTX offers online prenatal classes to pregnant STAR Kids members, at no cost. You can take an online class at any time in English and 15 other languages. Visit the STAR Kids member website at bcbstx.com/starkids to find out more about online classes and other resources for pregnant members. You will get a diaper bag filled with new baby items when you finish your BCBSTX prenatal class. When you complete the prenatal class online, you must fill out the certificate of completion found at the end of the lesson and fax it to 1‑512‑349‑4867. The diaper bag reward will be shipped to the address you write on the certificate. Call Member Outreach to register for an online class. Limitations: You must be an active BCBSTX STAR Kids member, be pregnant and take at least one prenatal class to get the diaper bag reward. Only one diaper bag per member will be awarded.

• Prenatal Incentive Gift Card: Pregnant STAR Kids members are eligible to receive a $25 gift card upon timely completion of the first prenatal visit. Limitations: Pregnant members must complete their first prenatal visit within the first trimester or within 42 days of enrollment with BCBSTX. Members must be active on the plan to receive the gift card reward.

• Postpartum Incentive Gift Card: STAR Kids members who deliver while on the BCBSTX plan are eligible to receive a $25 gift card upon timely completion of the postpartum visit. Limitations: Members who have delivered on the STAR Kids plan must complete the postpartum visit 7 to 84 days after delivery. Members must be active on the plan to receive the gift card reward.

• Breastfeeding Education through our Special Beginnings Program: Members who register for the Special Beginnings maternity program will have access to breastfeeding education information provided by Special Beginnings nurses.

The Special Beginnings maternity program can help you better understand and manage your pregnancy. When you register for Special Beginnings, you will get a Special Beginnings Service Manager. Your Service Manager is a specially trained nurse that will talk to you about how you and your baby are doing and will continue to call you up to six weeks after your baby is born. They can teach you how to make healthy choices for you and your baby, find pregnancy-related resources if you need them and work with your doctor if you have any special health needs during your pregnancy. If you are pregnant and would like to register for Special Beginnings, please call us toll-free at 1‑888‑421‑7781 (TTY 711) or email Special Beginnings at TXSBMedicaid@bcbstx.com. When you register for Special Beginnings, you can also qualify to get your choice of a free infant car seat or pack and play playard. Ask your Special Beginnings Service Manager how you can get these VAS.

• Fresh and Healthy Produce Delivery: Pregnant STAR Kids members can get up to $50 of fresh fruits and vegetables delivered to their home each year. Call Member Outreach to ask for help getting this VAS. Limitations: Members must be active on the BCBSTX plan and be pregnant when they ask for this VAS. The food items are limited to the BCBSTX approved list which may change depending on the vendor’s supply.

• In‑Home Meal Delivery Services: You can get a meal benefit that includes frozen meal delivery after a qualifying inpatient hospital discharge. Meal choices include breakfast, lunch and dinner. You can order up to 14 meals from the meal services provider for up to two separate events per year.Limitations: In-home meal delivery will only be available for two separate incidents per year for a maximum of 28 meals per year. Call your assigned service coordinator at 1‑877‑301‑4394 to ask for this Value-Added Service.

• Hippotherapy or Therapeutic Riding Services: BCBSTX offers up to 11 sessions of hippotherapy or therapeutic riding sessions each year. The sessions are provided by a certified American Hippotherapy Association (AHA) occupational or physical therapy facility, or at a Professional Association of Therapeutic Horsemanship International (PATH) facility to children who meet therapy or therapeutic riding qualifications. Work with your service coordinator to get approval for these services.Limitations: STAR Kids members can get this service after completing a therapy evaluation. The evaluation will help the therapist determine what service would be most helpful for the child and if the child can safely participate in the sessions. Members must have medical clearance from their PCP and may only participate in one of the two programs, hippotherapy or therapeutic riding. Therapy sessions are scheduled based on availability of certified providers. STAR Kids members can use the VAS transportation service to schedule rides to and from therapy. Members who already have hippotherapy services through waiver programs may not use this VAS. We offer a total of 11 sessions which includes one evaluation and 10 therapy sessions which must be used within the calendar year.

• Incentive Gift Card for Attending Member Resource Meeting: Each quarter, BCBSTX Member Advocates hold a Member Resource Meeting with help from our contracted provider, Texas Parent to Parent. Meetings are offered by phone or webinar and cover one educational topic at each meeting. These meetings give members tips on how to find their way through the health care system and a chance to share information and resources. Parents/LARs can get a $25 gift card for attending the resource meeting. Call the STAR Kids Member Advocate in your Service Delivery Area for details.Limitations: BCBSTX STAR Kids members, and parent/LARs can attend these meetings by phone or webinar as long as their child is enrolled in BCBSTX STAR Kids. One $25 gift card per member family will be given for each meeting attended. A member family can get up to four gift cards each year, for a total of $100 worth of gift cards.

• Blue365 Discount Program: Our Blue365 program offers discounts on various pharmacy over the counter (OTC) and health and wellness related services and items. The program is available to all STAR Kids members. You can get access to health and wellness items and offerings at a lower cost, as well as take advantage to some free/no cost services. This VAS excludes benefits covered by STAR Kids. Limitations: Members must register on the Blue365deals.com site for Texas. The information required for the registration process includes Name, Email, Password, ZIP Code, and alpha prefix. This alpha prefix is what is used to determine that a member is truly a HCSC Medicaid member.

• Aunt Bertha: BCBSTX offers Aunt Bertha, an online community resource where members can search for local community assistance with things such as rent, utilities and food. Members can also use Aunt Bertha to apply for assistance to any community-based programs or resources available on the site.Limitations: Call member outreach to get the link to the BCBSTX Aunt Bertha platform or find the link under the Member Programs and Resources section of the STAR Kids website. All eligible members can complete a self-referral to any community resource available on the platform.

• Online Behavioral Health (BH) Resources: STAR Kids members can access online Behavioral Health tools where they can login to get information that may help members get a better understanding of their specific behavioral health concerns. These online tools are extra services available to members 24/7. Limitations: Members must have login information to utilize this service as provided by Case Management.

• Incentive Gift Card for Getting Follow‑up Care after a BH Inpatient Discharge: Members are eligible to get a $25 gift card when they complete a follow-up visit with a behavioral health provider within seven days after a behavioral health hospitalization. Limitations: Members must attend a follow-up visit with a behavioral health provider within seven days following a discharge for mental illness or intentional self-harm diagnoses. Members must be enrolled in the plan to receive the gift card.

To learn more about programs and services for BCBSTX members, call the numbers or visit the website below.BCBSTX Customer Service 1‑877‑688‑1811 or (TTY 711)Member Advocate and Outreach (Central Service Area) 1‑855‑497‑0857

Member Advocate and Outreach (Travis Service Area) 1‑877‑375‑9097

BCBSTX Member Website www.bcbstx.com/starkids24 Hour Nurse Hotline 1‑855‑802‑4614 (TTY 711)Service Coordination 1‑877‑301‑4394 (TTY 711)Extra Help Getting a Ride VAS 1‑855‑933‑6993 (TTY 711)

To get auxiliary aids and services, or to get written or oral interpretation to understand the information given to you, including materials in alternative formats such as large print, braille or other languages, please call BCBSTX STAR Kids Customer Service at 1-877-688-1811 (TTY/TDD: 711).Blue Cross and Blue Shield of Texas complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-710-6984 (TTY: 711).CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-855-710-6984 (TTY: 711).Davis Vision is an independent company that has contracted with Blue Cross and Blue Shield of Texas (BCBSTX) to provide vision benefits administration for members with coverage through BCBSTX. Modivcare, formerly logisticare, is an independent company that has contracted with BCBSTX to provide transportation services for members with coverage through BCBSTX. Aunt Bertha is an independent company that provides community resource listings and discount programs for BCBSTX members.Blue365 is a discount program only for BCBSTX members. This is NOT insurance. Some of the services offered through this program may be covered under your health plan. Members should check their benefit booklet or call the Customer Service number on the back of their ID card for specific benefit facts. Use of Blue365 does not change monthly payments, nor do costs of the services or products count toward any maximums and/or plan deductibles. Discounts are only given through vendors that take part in this program. BCBSTX does not guarantee or make any claims or recommendations about the program’s services or products. Members should consult their doctor before using these services and products. BCBSTX reserves the right to stop or change this program at any time without notice. The relationship between the Blue365 vendors and BCBSTX is that of independent contractors.Hearing services are provided by American Hearing Benefits, BeltoneTM, HearUSA and TruHearing®. Vision services are provided by ContactsDirect®, Croakies, Davis VisionSM, EyeMed Vision Care, Glasses.com, Jonathan Paul Fitovers and LasikPlus®.BCBSTX makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.